Abstract 14555: Prognostic Impact of Echocardiographically Determined Left Ventricular Mass Severity According to the Proposed Categorization by the American Society of Echocardiography/European Association of Echocardiography (ASE/EAE)
Background: The ASE/EAE recommended the use of quantitative estimation of LV mass and defined sex-specific partition values empirically for mild, moderate and severe LV hypertrophy (LVH), based on standard deviation above or below the reference limit derived from a group of healthy people. However, the prognostic implication associated with this categorization is not known.
Methods: Among 2545 unselected adult outpatients referred to the Echo Lab for any indication, LVH was assessed by measuring LV mass using the ASE/EAE recommended formula and measurements convention from LV linear dimensions indexed to body surface area. Incident hospitalization for cardiovascular disease (CVD) (coronary heart disease, arrhythmias, heart failure) and death were the outcomes of the study.
Results: Of patients enrolled (mean age 61.9±15.8 yrs, 56.3% women), 1347 (52.9%) had normal LV mass, 391 (15.4%) mild, 307 (12.1%) moderate and 500 (19.6%) severe LVH. During a 2.5±1.2 yrs follow-up, there were 292 (11%) incident hospitalization for CVD and 121 (4.8%) deaths from all causes. LVH was associated with all outcome events. This relation persisted after adjusting for age, sex, common CV risk factors, LV ejection fraction, Wall Motion Score Index, significant valve disease and atrial fibrillation (HR 1.88, 95% CI 1.44–2.45, p< 0.001 for incident CVD, HR 3.1, 95% CI 2.07–4.65, p<0.001 for death from all causes). The adjusted HR for incident CVD was 1.24 for mild (95% CI 0.84–1.82, p=0.277), 2.02 for moderate (95% CI 1.42–2.88, p<0.001) and 2.38 for severe (95% CI 1.75–3.22, p<0.001) LVH. LVH categorization was also associated with all cause death: HR=1.81 (95% CI, 1.03–3.20, p=0.04) for mild, 2.31 (95% CI 1.33–4.01, p=0.003) for moderate and 2.30 (95% CI 1.39–3.79, p=0.001) for severe LVH.
Conclusion: Among unselected adult outpatients referred to the Echo Lab, the categorization of LV mass by the ASE/EAE recommendations offers prognostic information beyond other common CV risk factors.
- © 2010 by American Heart Association, Inc.